Fungal meningitis following epidural steroid injections

Here are two recent reports from NEJM about the outbreak, traced to a compounding pharmacy [1] [2].

Of interest:

61 deaths were reported.

Strokes, mainly posterior circulation territory, were reported as complications.

This was the largest outbreak of health care related infection ever reported in the US.

Two organisms, Aspergillus fumigatus and Exserohilum rostratum, were identified in clinical infections.

Fungal infections of the CNS may be prone to chronicity and relapse, so final outcomes remain unknown in many patients.